Dural tears can occur during spinal surgery and may lead to cerebrospinal fluid (CSF) leakage which is rarely involved in remote cerebellar hemorrhage. Only a few of cases of simultaneous cerebral and cerebellar hemorrhage have been reported in the English literature. We experienced a case of multiple remote cerebral and cerebellar hemorrhages in a 63-year-old man who exhibited no significant neurologic deficits after spinal surgery. Magnetic resonance imaging (MRI) performed 4 days after the surgery showed a large amount of CSF leakage in the lumbosacral space. The patient underwent the second surgery for primary repair of the dural defect, but complained of headache after dural repair surgery. Brain MRI taken 6 days after the dural repair surgery revealed multifocal remote intracerebral and cerebellar hemorrhages in the right temporal lobe and both cerebellar hemispheres. We recommend diagnostic imaging to secure early identification and treatment of this complication in order to prevent serious neurologic deficits.
Brain ; Diagnostic Imaging ; Headache ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Neurologic Manifestations ; Temporal Lobe

Dural tears can occur during spinal surgery and may lead to cerebrospinal fluid (CSF) leakage which is rarely involved in remote cerebellar hemorrhage. Only a few of cases of simultaneous cerebral and cerebellar hemorrhage have been reported in the English literature. We experienced a case of multiple remote cerebral and cerebellar hemorrhages in a 63-year-old man who exhibited no significant neurologic deficits after spinal surgery. Magnetic resonance imaging (MRI) performed 4 days after the surgery showed a large amount of CSF leakage in the lumbosacral space. The patient underwent the second surgery for primary repair of the dural defect, but complained of headache after dural repair surgery. Brain MRI taken 6 days after the dural repair surgery revealed multifocal remote intracerebral and cerebellar hemorrhages in the right temporal lobe and both cerebellar hemispheres. We recommend diagnostic imaging to secure early identification and treatment of this complication in order to prevent serious neurologic deficits.
Brain ; Diagnostic Imaging ; Headache ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Neurologic Manifestations ; Temporal Lobe

An 18-year-old man suffered heat stroke after continuous working for 26 hours on his first day in an aluminium utensil plant in August 1998. His job was to put a pressed aluminium utensil on the conveyer before the process of spray painting. The ranges of temperature and relative humidity measured at the local weather-station during the patient' s working period were 23.6-30.2 degrees C, 49-87 % respectively. On arrival the patient was comatose and suffered generalized seizure three times. His rectal temperature was 41.2 degrees C . blood pressure was 90/60 mmHg, pulse was 148 beats/minute and respiratory rate was 28 times/minute. The serum level of AST was 421 IU/L. ALT was 205 IU/L, LDH was 1,160 IU/L. myoglobin was higher than 500 ng/mL. OK was higher than 2,000 IU/L. He recovered consciousness 7th day of admission and discharged after 2 months but cerebellar dysarthria was remained. The patient felt himself several prodromal symptoms of heat stroke and he showed awkward behavior considered to be drowsiness, but the patient and his co-workers neglected them. This case report shows that heat stroke can be occurred in a condition that ambient temperature, humidity, and working load are not extreme. A thorough health education and management concerned with guidelines on salt and water intake, detection of early symptoms of heat-related illness, prompt body cooling and rapid transportation to a hospital is necessary.
Adolescent ; Blood Pressure ; Coma ; Consciousness ; Drinking ; Dysarthria ; Health Education ; Heat Stroke* ; Hot Temperature* ; Humans ; Humidity ; Myoglobin ; Paint ; Paintings ; Plants* ; Prodromal Symptoms ; Respiratory Rate ; Seizures ; Sleep Stages ; Transportation

Pigmented Spitz nevus is a benign melanocytic skin lesion with distinct clinical features and it is frequently found on the extremities. However, it rarely occurs on acral area of the body, and such a case has not yet been fully documented. We present a case of acral pigmented Spitz nevus occurring on the foot, and this mimicked acral lentiginous malignant melanoma. Clinicians should be well aware of this entity and its possible clinical presentations. Since acral pigmented Spitz nevus is benign in nature, making the correct diagnosis is important to avoid unnecessary mutilating or excessive surgery.
Extremities ; Foot ; Melanoma ; Nevus, Epithelioid and Spindle Cell ; Skin

Central serous chorioretinopathy (CSCR) is an idiopathic disorder characterized by serous detachment of the macula and retinal pigment epithelial (RPE) detachment. Its etiology and pathophysiology are still unknown. However, CSCR can arise secondary to chronic treatment with steroids. We present two cases in which CSCR developed in patients on oral steroid therapy and resolved after treatment was stopped. We also offer a review of the literature.
Central Serous Chorioretinopathy ; Glomerulonephritis ; Humans ; Retinaldehyde ; Steroids

No abstract available.
Axons ; Hand ; Humans

Purpose: This study aimed to examine changes in nurse staffing grades and nursing fee revenues following the third amendment of the resource-based relative value scale, implemented in January 2024. Methods: Revised nurse staffing grades were determined based on the number of patients per nurse (PpN), calculated by dividing the daily patient census by the number of registered nurses working in general wards. Changes in staffing grades were analyzed from the fourth quarter of 2023 to the first quarter of 2024 among 44 tertiary hospitals, 328 general hospitals, and 1,378 non-general hospitals. Results: In 2024, the previous "best grade" (grade 1) was subdivided into two or three grades. The best grade was redefined as grade S (PpN<1.5) in tertiary and general hospitals and grade A (PpN<2.0) in non-general hospitals. By 2024, 72.4%, 11.8%, and 22.5% of tertiary, general, and non-general hospitals, respectively, achieved the best grade. The estimated additional annual nursing fee revenues per nurse in 2024 (compared to 2023) for hospitals advancing from grade 1 to grade S ranged from 1,088,455 to 11,412,655 KRW in tertiary hospitals and 11,483,834 KRW in general hospitals. Conclusion To ensure appropriate nurse staffing levels, nursing fees should be proportionally differentiated based on staffing requirements. Additional revenues should be strategically allocated to enhance nurse compensation, thereby improving workforce sustainability and care quality.

Purpose: This study aimed to examine changes in nurse staffing grades and nursing fee revenues following the third amendment of the resource-based relative value scale, implemented in January 2024. Methods: Revised nurse staffing grades were determined based on the number of patients per nurse (PpN), calculated by dividing the daily patient census by the number of registered nurses working in general wards. Changes in staffing grades were analyzed from the fourth quarter of 2023 to the first quarter of 2024 among 44 tertiary hospitals, 328 general hospitals, and 1,378 non-general hospitals. Results: In 2024, the previous "best grade" (grade 1) was subdivided into two or three grades. The best grade was redefined as grade S (PpN<1.5) in tertiary and general hospitals and grade A (PpN<2.0) in non-general hospitals. By 2024, 72.4%, 11.8%, and 22.5% of tertiary, general, and non-general hospitals, respectively, achieved the best grade. The estimated additional annual nursing fee revenues per nurse in 2024 (compared to 2023) for hospitals advancing from grade 1 to grade S ranged from 1,088,455 to 11,412,655 KRW in tertiary hospitals and 11,483,834 KRW in general hospitals. Conclusion To ensure appropriate nurse staffing levels, nursing fees should be proportionally differentiated based on staffing requirements. Additional revenues should be strategically allocated to enhance nurse compensation, thereby improving workforce sustainability and care quality.

Purpose: This study aimed to examine changes in nurse staffing grades and nursing fee revenues following the third amendment of the resource-based relative value scale, implemented in January 2024. Methods: Revised nurse staffing grades were determined based on the number of patients per nurse (PpN), calculated by dividing the daily patient census by the number of registered nurses working in general wards. Changes in staffing grades were analyzed from the fourth quarter of 2023 to the first quarter of 2024 among 44 tertiary hospitals, 328 general hospitals, and 1,378 non-general hospitals. Results: In 2024, the previous "best grade" (grade 1) was subdivided into two or three grades. The best grade was redefined as grade S (PpN<1.5) in tertiary and general hospitals and grade A (PpN<2.0) in non-general hospitals. By 2024, 72.4%, 11.8%, and 22.5% of tertiary, general, and non-general hospitals, respectively, achieved the best grade. The estimated additional annual nursing fee revenues per nurse in 2024 (compared to 2023) for hospitals advancing from grade 1 to grade S ranged from 1,088,455 to 11,412,655 KRW in tertiary hospitals and 11,483,834 KRW in general hospitals. Conclusion To ensure appropriate nurse staffing levels, nursing fees should be proportionally differentiated based on staffing requirements. Additional revenues should be strategically allocated to enhance nurse compensation, thereby improving workforce sustainability and care quality.

Purpose: This study aimed to examine changes in nurse staffing grades and nursing fee revenues following the third amendment of the resource-based relative value scale, implemented in January 2024. Methods: Revised nurse staffing grades were determined based on the number of patients per nurse (PpN), calculated by dividing the daily patient census by the number of registered nurses working in general wards. Changes in staffing grades were analyzed from the fourth quarter of 2023 to the first quarter of 2024 among 44 tertiary hospitals, 328 general hospitals, and 1,378 non-general hospitals. Results: In 2024, the previous "best grade" (grade 1) was subdivided into two or three grades. The best grade was redefined as grade S (PpN<1.5) in tertiary and general hospitals and grade A (PpN<2.0) in non-general hospitals. By 2024, 72.4%, 11.8%, and 22.5% of tertiary, general, and non-general hospitals, respectively, achieved the best grade. The estimated additional annual nursing fee revenues per nurse in 2024 (compared to 2023) for hospitals advancing from grade 1 to grade S ranged from 1,088,455 to 11,412,655 KRW in tertiary hospitals and 11,483,834 KRW in general hospitals. Conclusion To ensure appropriate nurse staffing levels, nursing fees should be proportionally differentiated based on staffing requirements. Additional revenues should be strategically allocated to enhance nurse compensation, thereby improving workforce sustainability and care quality.